Can you deliver 67th? Iatrogenic impotence!

Sometimes in my pharmacy, a particular complaint becomes the order of the day. You can see like ten people complaining about sore throat like they were sent to you because you have become the expert in sore throat treatment. That is why pharmacists must be at alert to be able to detect when an epidemic sets in. Today, it was neither sore throat nor an epidemic but a problem that is gradually becoming common in men diminishing their bedroom status.
They were both on antihypertensives and I had reason to tell them to gradually withdraw from one of their medications and revisit their cardiologists. What class of antihypertensives are implicated in this?

7 comments

The antihypertensive implicated in impotence are the Centrally active group of which Methyldopa is an example. Drug-induced effects include diminished libido, delayed orgasm, ejaculatory disturbances, gynecomastia, impotence, and priapism. The pharmacologic mechanisms proposed to account for these adverse effects include adrenergic inhibition, adrenergic-receptor blockade, anticholinergic properties, and endocrine and sedative effects. The most frequently reported adverse effect on sexual function with the antihypertensive agents is impotence. It is seen most often with methyldopa, guanethidine, clonidine, and propranolol. Drug-induced sexual dysfunction may be alleviated by switching to agents with dissimilar mechanisms to alter the observed adverse effect while maintaining adequate control of the patient’s disease state. Cheers